Y O U R H E A L T H P O L I C Y Valid from 1 July 2011

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1 YOUR HEALTH POLICY Valid from 1 July 2011

2 Contents Why you need health cover in Australia What you need to know What you re covered for What you re not covered for Waiting periods Important terms you need to know Services for overseas students Emergency service helpline How to renew your cover Adding extras cover Feedback Privacy policy IMPORTANT Goods and Services Tax (GST) It is your responsibility to advise ahm if you have any entitlement to claim GST as an input tax credit. (See page 17 for more information) For further information please contact ahm on Private Health Insurance Code of Conduct ahm adheres to the Private Health Insurance Code of Conduct. This is a selfregulatory code that promotes informed relationships between private health insurers, consumers, agents and brokers. Our documents display the PHI Code of Conduct logo. This shows that ahm complies with the Code and has been authorised by the Code Compliance Committee to use the logo. If you d like more information about the Code or if you d like your own copy of the Code call one of our friendly staff on or go to ahm.com.au

3 Congratulations on choosing to study in Australia. We hope that while you re here you enjoy good health. If you get ill while studying, your Overseas Student Health Cover with ahm will help you with your medical bills. Overseas Student Health Cover is only available to holders of a student visa, or dependants of that student if authorised to enter and remain in Australia with the overseas student. If your student visa status changes, you will need to change to a different health insurance cover, so you should contact us immediately on About your Overseas Student Health Cover (OSHC) Your Overseas Student Health Cover provides you with benefits for services in hospital and out of hospital. It also covers you for emergency ambulance transport, prescription medicines and hospital accommodation at most private and all public hospitals across Australia. This policy document has been designed to help you understand your ahm OSHC benefit entitlements and ahm OSHC terms and conditions. It also provides you with a step-by-step guide that explains what you need to do if you have to go to hospital. Important The terms and conditions in this policy document may vary from time to time. It is your responsibility to keep up-todate with the terms and conditions of your cover. To download the latest version of this policy booklet go to ahm.com.au/oshc Please read this document carefully and keep an up-to-date copy in a safe place for future reference. Remember, if you need to go to hospital, call us first if you can. 1

4 Here s a snapshot of the great benefits you get with ahm OSHC. Help with the costs of medical treatment 24 hour emergency service helpline for: Emergency medical assistance Stress and trauma counselling Interpreter service Online claiming services, any time of the day or night Informative website ahm.com.au/oshc Your choice to extend your cover to include popular services like dental, optical and physiotherapy (see page 17 for more information) Translated information on the website Health information sheets. Why you need health cover in Australia The Department of Immigration and Citizenship (DIAC) requires visitors with a student visa to have Overseas Student Health Cover for the length of your Visa. Australia s national health care program, Medicare, doesn t cover you. ahm OSHC pays towards the cost of medical bills. For example, the cost of treatment in a public hospital could be as high as $2,500 a day but ahm OSHC pays it for you. How long you need to be covered You need health cover as a condition of your student visa, so you must be covered for the full length of your visa to its end date. When applying for your visa, you will be asked to provide evidence of your cover. What happens if you don t renew your Overseas Student Health Cover? ahm is required to provide your details to the Department of Immigration & Citizenship (DIAC) if you cancel or don t renew your cover. Holding Overseas Student Health Cover for the whole time you are in Australia is a condition of your visa, so your visa status may be reviewed by DIAC. 2

5 If you don t have Overseas Student Health Cover and you have an accident or need medical attention, you will have to pay for the treatment. If you allow your cover to lapse for any reason, when you renew your Overseas Student Health Cover you will have to back-pay for any period that you were not covered by Overseas Student Health Cover to your new visa end date. In addition, you are not entitled to receive benefits for periods where you were not covered by Overseas Student Health Cover, even if you re-activate your policy and backdate your payments for that period. This may result in you having to pay significant hospital, medical or other costs yourself. What you need to know Paying for your cover You must provide proof of purchase of your Overseas Student Health Cover in your application for your visa or in your application for an extension of your visa. If you applied for a visa before 1 July 2010, when you renew your cover, you will need to pay to the end date of your visa. Refunds ahm can only pay a refund on your premiums if one of the following circumstances occur: You did not take up your studies in Australia. Your student visa has been cancelled or your visa status changes. You are obliged to cease studies in Australia and return home. You have been granted permanent residency or an Australian visa (other than student visa). You will need to provide us with proof of these circumstances should you require a refund. A fee may be charged. If you transfer to another OSHC provider, you will need to provide us with a certificate of your insurance showing evidence of paid cover for the full visa term before we refund any unused portion of your premiums. As requested by the Department of Health & Ageing (DoHA), ahm is required to advise DIAC should you cancel your policy with ahm. Remember to keep your cover up to date. It is your responsibility under your visa conditions to maintain Overseas Student Health Cover for the whole time you are in Australia and to advise ahm if your circumstances change. 3

6 Your membership card You must keep your ahm OSHC membership card safe and tell us immediately if your card is lost or stolen. You must not allow any person who is not covered by your ahm OSHC policy to use your card. Any fraudulent misuse of your card may result in your policy being cancelled and DIAC being advised. ahm will not be responsible for any loss to you or use of your policy limits as a result of misuse of your card. Policy renewal If you applied for your visa before 1 July 2010 and you don t have cover for the full length of your visa, renewing your policy is easy, just log onto ahm.com.au/oshc and click on renew. If you apply to extend your visa, you need to contact us and pay for the additional time you ll be studying so that your certificate can accompany your visa extension application. Visa and passports ahm may ask you to provide a copy of the passport and/or visa for any person covered by ahm OSHC to assess eligibility to make a claim before paying benefits. You consent to ahm verifying your visa details with DIAC. Suspending your health insurance policy If you re travelling overseas for more than 30 days, you can suspend your ahm OSHC policy while you are away. To suspend your policy just or ring us a couple of weeks before you leave to let us know the dates of your travel. You will be asked to send a copy of your itinerary or airline tickets to confirm the date of departure and arrival. We must receive this information or we won t be able to process the suspension. We can only suspend your policy before you leave Australia. If you do not apply before you leave Australia, you will not be able to suspend your membership for the period you were absent after you return. We ll reactivate your policy from your advised date of return. A letter will be sent to you when this happens. It's very important for many reasons that we reactivate your policy on the date you arrive back in Australia. If, for any reason you return to Australia on a date other than what you originally told us, you must contact us with 30 days of returning with proof of the new return date. 4

7 If you don t do this, it may result in the cancellation of your policy and you will be in breach of your Visa conditions. Note: All people covered by the policy must be overseas for the policy to be suspended. You ll still need to serve any outstanding waiting periods you may have had before leaving the country. You can t claim any benefits while your policy is suspended so we recommend you consider purchasing Travel Insurance to protect you from any emergency that may occur. Date paid to or current financial date This is the date that your ahm OSHC policy is paid to. After this date, you won t be insured and we won t pay benefits. Single policy This policy covers the student only. Family policy Your spouse or de facto partner and your dependant children under 18 years of age can be covered under an ahm OSHC family policy if they: are authorised to enter Australia under the student s visa live with you while you re studying. We don t cover members of your family such as parents, grandparents, brothers, sisters, uncles or aunts. Pregnancy related services For all new policies purchased on or after 1 July 2011, a 12 month waiting period applies for all pregnancy related services including childbirth. This means that if you have taken out your Overseas Student Health Cover on or after 1 July 2011 and have been in Australia on a student visa for less than 12 months, you won t be covered for any pregnancy related services. This waiting period doesn t apply if you require Emergency Treatment. Having a baby? If you are already on an ahm OSHC single policy, have served your waiting period and you become pregnant, you will need to change your cover to a family policy to cover your baby. You will need to do this at least two months before the baby s birth. This rule also applies to premature births. If you wait until after the birth of your baby to change your cover, then your baby will have to serve all waiting periods. 5

8 If you are already on an ahm OSHC family policy and you become pregnant you will need to advise us of the birth of the newborn child. The child will be covered from their date of birth as long as: you notify ahm within 2 months of the newborn s date of birth, and you have had an ahm OSHC family policy for at least 2 months prior to the date of birth. How we communicate with you While you are with ahm OSHC, we may need to send you information about your policy. This can include an important update to policy information, a reminder that your policy needs renewing or you may have lost your card and need a new one. That means it s very important that your contact details are up to date. If we post or fax the correspondence to you or your institution (which is then responsible for passing that correspondence on to you), any correspondence we send is deemed to have been received by you: a) within 2 business days after it is posted by us or; b) if faxed, the day after it is sent, provided that successful transmission is confirmed. Updating your contact details You must let us know if your personal details change. Please contact us as soon as possible if: you change your contact details such as your address, telephone number or address your partner and/or dependants are coming to Australia to live with you your partner and/or dependants are no longer living with you you or your partner is pregnant you are applying for another visa. To update your details, you can call us on and we ll update your details for you or you can go online at ahm.com.au/oshc and use your password to log into the members section. 6

9 What you re covered for Please read the following information carefully and contact us if you have any questions. If you need treatment in a hospital, please call us on to confirm your benefits and entitlements. Doctors bills For treatment in a Doctor s surgery or at home by a General Practitioner (GP) or anywhere outside a hospital We pay 100% of the published MBS fee or the amount as determined by the Federal Government for standard GP consultations (please see page 14 for more information) 85% of the published MBS fee or the amount as determined by the Federal Government for other out of hospital services and you pay the difference. For treatment in a hospital We pay 100% of the MBS fee. Important If you need to see a doctor, you can choose any doctor you wish You should always ask your doctor how much they re going to charge you If the doctor charges more than the MBS fee, you pay the difference. Pathology & X-rays For services such as blood tests and X-rays We pay 100% of the published MBS fee or the amount as determined by the Federal Government for in hospital services 85% of the published MBS fee or the amount as determined by the Federal Government for out of hospital services and you pay the difference. 7

10 Hospitals For treatment in partner private hospitals or day surgeries We pay the full cost of private or shared room accommodation, theatre fees and same day services up to the MBS fee for treatment by your doctor for accident and emergency services where applicable for outpatient medical and post operative services. (See page 7 for what we pay on doctors bills) For treatment in all public hospitals We pay the full cost for shared accommodation, theatre fees and same day services up to the MBS fee for treatment by your doctor for accident and emergency services for outpatient medical and post operative services. (See page 7 for what we pay on doctors bills). Important Private or public? It s your choice. If you need to go to hospital, you can choose to have your treatment at either a private or public hospital. Hospital bills are normally sent straight to us for payment. If there s a difference between the ahm OSHC benefit and the hospital charge, you ll need to pay this on admission. If the private hospital you re treated in is not a partner hospital, you ll have to pay the difference between the ahm OSHC default benefit and the hospital s charge on admission (this could be quite a large amount). Call us beforehand to make sure you re being treated in a partner private hospital. 8

11 Emergency treatment Emergency treatment means the treatment of any of the following conditions: a risk of serious morbidity or mortality and requiring urgent assessment and resuscitation; or suspected acute organ or system failure; or an illness or injury where the viability of function of a body part or organ is acutely threatened; or a drug overdose, toxic substance or toxin effect; or psychiatric disturbance whereby the health of the patient or other people is at immediate risk; or severe pain where the viability of function of a body part or organ is suspected to be acutely threatened; or acute haemorrhaging and requiring urgent assessment and treatment; or a condition that requires immediate admission to avoid imminent morbidity or mortality and where a transfer to another facility is impractical This will need to be verified by the treating medical practitioner. Ambulance services For emergency transport in an ambulance We pay 100% of the cost. Important Emergency transportation means a sudden or unexpected need for hospitalisation where the only practical way of getting to a hospital is by ambulance. If you call an ambulance for services other than emergency hospital transportation, you ll have to pay the full cost. 9

12 Prescription medicines For medicines and other prescription items prescribed by your doctor You pay a set amount towards the cost and we pay the rest up to a maximum of $50 per item. (See page 15 for more information) We pay The difference between the current PBS amount and the cost of the item up to $50 per item. Maximum benefit: $300 per calendar year for single members $300 per person up to a maximum of $600 for a family policy. Important Benefits are only payable on pharmacy items that are prescription only and prescribed by a medical practitioner and are essential to treat a particular illness, injury, or condition No benefits are payable on over the counter medicines, vitamins or herbal medicines You ll need to pay the Pharmacist first and then claim it back from us As an overseas student, you may face significant out-of-pocket costs if you need treatment with high cost pharmaceuticals, particularly oncology (cancer) treatment. Prostheses We cover you for the agreed charge We ll cover the full cost of any No Gap prostheses and the minimum benefit for Gap Permitted prostheses. Important If you choose a Gap Permitted prosthesis that costs more than the minimum benefit, you ll have to pay the difference between the minimum benefit and the prosthesis charge. There is at least one clinically appropriate No Gap prosthesis available for any procedure you may require so you should discuss the choices with your doctor. 10

13 What you re not covered for Services not covered by Medicare such as cosmetic surgery or laser eye treatment. Treatment for pre-existing medical conditions. (See Waiting periods for pre-existing conditions on page 12) Any Pregnancy Related Services in the first 12 months. (See Pregnancy Related Services on page 5) Psychiatric services within the first 2 months. Assisted reproductive services such as in-vitro fertilisation (IVF). Services/treatment covered under compensation and damages provisions of any kind, for example, motor vehicle accidents covered by third party insurance. Fees charged by your doctor above the Medicare Benefits Schedule (MBS). Transportation of you or your dependants into or out of Australia in any circumstance. Treatment received outside of Australia. Treatment for any of your children who are over 18 years of age. Treatment by dentists or other extras services such as glasses and physiotherapy unless this treatment is related to a hospital stay and is included in the hospital s contract. You can be covered for this if you buy extras cover. (See page 17 for more information) Items provided to you on discharge from a hospital including medication and crutches. Personal expenses in hospital including telephone calls, television hire and newspapers. Services or treatment for which a claim has been submitted more than two years after the date of service or treatment. Treatment organised before you or your dependants arrived in Australia. 11

14 Waiting periods When you take out ahm OSHC you ll have to wait a set time before you can claim for services and benefits. If you applied for your student visa before coming to Australia your waiting periods will start from the date of arrival in Australia. If you applied for your student visa whilst already living in Australia your waiting periods will start from your date of purchase. If you ve transferred from another Overseas Student Health Cover provider to ahm OSHC, we ll recognise the waiting periods you have already served with the other Overseas Student Health Cover provider. Waiting period 2 months Service Pre-existing condition of a psychiatric nature 12 months Pre-existing medical conditions and pregnancy related services including childbirth See page 14 for a definition of pre-existing medical conditions. Important terms you need to know Accidents If you require treatment for an accident, you ll be covered from the day you joined and made your first payment. Benefit This is the amount that we ll pay for services or treatments you receive that are covered by this policy. Compensable claims Services and/or treatment covered under compensation and damages provisions of any kind, for example, motor vehicle accidents covered by third party insurance. Day only surgery This is when you re admitted to a hospital and discharged on the same day. 12

15 Default benefit We ll pay the default benefit for accommodation as set by the Commonwealth Government. Emergency treatment See page 9. General Practitioner (GP) A General Practitioner is a doctor who is not a specialist or consultant. In hospital treatment Where you or a person on your policy is admitted to a hospital or treated in a hospital as a result of an accident or an emergency. Institution This refers to a school, high school, TAFE College, English Language Centre, University or any other education provider. Limits This is the maximum amount you can claim each calendar year (January to December) for certain treatments. Unless specified, limits apply to each person covered by your policy. Medicare Medicare is Australia s national health care program for all permanent residents of Australia. It provides treatment as a public patient in a public hospital, and free or subsidised medical treatment by practitioners such as doctors, specialists and participating optometrists. Medicare is not available to overseas students. Reciprocal Medicare card Overseas Student Health Cover is compulsory under the terms of your student visa but if you come from UK, Malta, Italy, Republic of Ireland, Finland, The Netherlands, Norway, Belgium or Sweden you are eligible for a Yellow Reciprocal Medicare Card. You should apply for one at your local Medicare office. The Yellow Reciprocal Medicare Card provides you with access to Medicare for medically necessary treatment in a public hospital. Medically necessary means any ill health or injury which occurs while you are in Australia and requires treatment before you return home. This card also gives you access to the Pharmaceutical Benefits Scheme (PBS) and out of hospital treatment provided by doctors. If you hold a Reciprocal Medicare Card, you can choose to be treated either under Medicare (where appropriate) or your Overseas Student Health Cover depending on the circumstances and the costs involved. 13

16 Medicare Benefits Schedule The Medicare Benefits Schedule (MBS) is a list of fees for medical procedures and treatments provided by doctors including specialists and General Practitioners. A doctor can choose to charge more than these fees. Before being treated, make sure you ask your doctor how much your treatment will cost so you know what you might have to pay. If your doctor charges more than the MBS fee you ll have to pay the amount above the MBS fee. Out of hospital treatment Means where you or a person on your policy receives medical services without being admitted to a hospital. Out of hospital can refer to GP and specialist consultations, some X-rays and pathology. Partner private hospitals ahm has agreements with many private hospitals and day surgeries throughout Australia. We ll cover you at these hospitals for the full cost of theatre and accommodation charges. Pharmaceutical Benefits Scheme (PBS) The PBS is the national pharmaceutical benefits scheme funded by the Commonwealth Government where patients pay only part of the cost of a subsidised drug. The rest of the cost is paid by the PBS. Pre-existing medical conditions An Overseas Student or a Dependant of the Overseas Student insured under an Overseas Student Health Insurance policy has a pre-existing condition if: (a) the Overseas Student or the Dependant of the Overseas Student has an ailment, illness or condition; and (b) in the opinion of a Medical Practitioner appointed by ahm, the signs or symptoms of that ailment, illness or condition existed at any time in the period of 6 months ending on the day on which the Overseas Student or the Dependant of the Overseas Student arrived in Australia. In forming this opinion, ahm s Medical Practitioner must have regard to any information in relation to the ailment, illness or condition that the Medical Practitioner who treated the ailments, illness or condition gives him or her. You need to give us consent to do this or we will not be able to assess your claim. 14

17 Prescription medicines ahm OSHC provides benefits for most medicines prescribed by a doctor. For each prescription item you buy, you have to pay part of the cost. (See Pharmaceutical Benefits Scheme on page 14). We ll pay the rest up to a maximum of $50 each prescription item. If your doctor has prescribed several medicines on the same prescription, each item will count as a separate claim. If the medication is being prescribed to treat a pre-existing medical condition we will not pay the claim. Prostheses This term refers to surgically implanted items such as stents (for coronary arteries), grommets, artificial hips and knees, or titanium plates and screws (used in reconstructions or bone breaks). Commonwealth legislation allows for a Prostheses Gap payment for a small number of prostheses. These prostheses are referred to as Gap Permitted prostheses and aren t fully covered. This means if there is a gap, you ll have to pay it. A large number of prostheses listed on the Government s Prostheses list are No Gap prostheses. These are fully covered by ahm and there s at least one clinically appropriate No Gap prosthesis for any procedure you may require. If you need a prosthesis, please discuss the choices with your doctor prior to giving your doctor consent. This will allow you to make a fully informed decision about the cost of your treatment. If you choose a Gap Permitted prosthesis that costs more than the minimum benefit, you ll have to pay the difference between the minimum benefit and the prosthesis charge. Services for overseas students Using the web Make an extras claim Update your contact details Renew your cover Request a new membership card Making a claim You can claim for: Access general health information Find information about ahm OSHC in other languages. hospital treatment visits to your doctor (out of hospital) pharmacy items specialists X-rays pathology. 15

18 Online and telephone claims You can only claim online or over the phone for services you have already paid. 1. Log onto ahm.com.au/oshc or call We ll deposit your benefit into your preferred Australian bank account (normally within 2 working days). 3. We ll send you a letter to confirm your claim, so make sure your contact details are up to date. You need to attach your receipt/s to this letter and send it back to us. NOTE: If you reach the $200 combined limit for online and telephone claiming, you can t make any more claims over the phone or online until we have received your receipts. Once we have your receipts, you can claim up to $200 again. Postal claims Fill in a claim form, include receipts and mail it to: ahm OSHC, Locked Bag 1006, Matraville NSW We can either deposit the benefit in your bank account or send you a cheque. NOTE: If you haven t paid the bill fill in a claim form and mail us the bill. We ll send you a cheque that s payable to your service provider. This might be your doctor, hospital or ambulance service. When you receive the cheque, you must send it to the provider and include any additional amount that you may be required to pay. All claims will be paid in Australian dollars. Direct billing no need to pay and claim When you visit a medical centre or GP that has a direct billing arrangement with ahm OSHC, we ll pay them the amount equal to the MBS fee for the service provided to you. This means you don t have to pay for the standard GP consultation and claim later. To find the nearest direct billing medical centre or GP near you, use ahm OSHC s online search function and select the state in which you live. You must show your ahm OSHC membership card at reception to use this service. NOTE: ahm OSHC only pays the amount equal to the MBS fee for standard GP consultations (see page 14 for more information Medicare Benefits Schedule). If your doctor charges above the MBS fee you will have to pay the difference. Any amount above the MBS fee cannot be claimed. Go to ahm.com.au/oshc and search for a participating medical centre near you. 16

19 Emergency service helpline hours, 7 days a week Emergency medical assistance A registered nurse will direct you to the most appropriate level of care needed for your condition and if required, to a specialist practicing physician. Stress and trauma counselling You will be connected to a qualified counsellor for an initial discussion over the phone. The counsellor will help you develop strategies to move forward and may suggest an appointment in person for further assistance. Interpreter service If you need interpreter assistance, call and tell them your name and preferred language. This service is available 24 hours, 7 days a week and does not have to be for a medical service. How to renew your cover Online Log onto ahm.com.au/oshc and fill in the online application form; or Download the form and send it to us. Phone Call Adding extras cover Your ahm OSHC only provides cover for hospital and medical treatment. It doesn t include things like visits to the dentist, eye checks, glasses or chiropractic. If you want cover for these services, you can buy one of our OSHC extras covers. This cover is not a substitute for your visa requirement and can only be purchased in addition to your ahm OSHC policy. Waiting periods apply. For more information or a brochure on extras, call How to join ahm OSHC Log onto ahm.com.au/oshc and fill in the online application form: or Download the form and send it to us. 17

20 Transferring your Overseas Student Health Cover policy If you re with another health insurer, you can transfer to us at any time. Just call us to find out how. Goods and Services Tax (GST) Overseas Student Health Cover is subject to GST which is included in the premium you pay. If you purchase ahm OSHC it is assumed you have no entitlement to claim any part of the GST as an input tax credit. If at any time you are eligible and intend to claim back part or all of the GST, you must notify us in writing. Feedback At ahm Health Insurance, we work hard to make sure you always get the best service when you need it and we welcome your feedback. Whether you re making a suggestion, paying a compliment or making a complaint, your feedback is important to us. If you have a suggestion about how ahm can improve our products or service, please let us know. If you re ever unhappy about something we ve done - or perhaps not done - please give us the opportunity to put things right. We use your de-identified feedback for training and coaching purposes so that we can improve our products and services. Online: Use the contact us form choose your subject at the top of the form Phone: Mail: Call our friendly staff in the Member Service Centre on ahm member feedback Locked Bag 1006 Matraville NSW 2036 Fax:

21 Complaints If you have a complaint related to your policy, please let us know straight away so that we can work to resolve matters as soon as possible. Where possible, we ll resolve your issue on the spot. However, if we re unable to resolve your issue immediately, we ll refer it to our Customer Advocacy Team who ll undertake a detailed investigation. Customer Advocacy Team Our Customer Advocacy Team will aim to find a solution for you by investigating your complaint and then letting you know the result. They will: investigate the issue keep you informed aim to resolve the issue within 21 days To help us in this process, please provide as much information as possible about the nature of your complaint. Please include your name, and membership number (if applicable), on all correspondence. What if I m not satisfied? If you re not satisfied with the steps taken by ahm to resolve your complaint or with the result of our investigation, you can request a review of your complaint by the Private Health Insurance Ombudsman. Private Health Insurance Ombudsman We will do our best to resolve the issue to your satisfaction. If you re unhappy with the result, you can contact the Private Health Insurance Ombudsman (PHIO) for free independent advice. Phone: Address: Suite 2, Level 22, 580 George Street Sydney NSW 2000 Website: phio.org.au 19

22 ahm privacy policy Your privacy is important to us Australian Health Management Group Pty Limited (ahm) is subject to the Privacy Act 1988 and complies with the principles for handling your personal information. You can contact us anonymously. However, if you choose not to be identified, we are very limited in our ability to insure you, pay claims or offer you services. Your privacy and personal information is important to us and we will do each of the following: only collect, use and disclose personal information about you that is required in the provision of information about or the promotion or delivery of our products and services to you; administration of ahm s business; business analysis; or to meet any legal obligations imposed on ahm (Purpose). only disclose your personal information to third parties for a Purpose and with whom we have entered into an agreement that gives you (or that the law requires to give you) at least the same level of protection to your personal information as we do. only use de-identified information for any statistical or other analysis or similar research purposes. only disclose your information to a third party in connection with a product or service offered by that third party with your prior consent. only transfer your personal information outside Australia or health information outside New South Wales if it is in accordance with the law and is necessary for any of the following: to prove your cover with another private health insurer and to confirm waiting periods have been served. to investigate claims. for the administration or delivery of health insurance, health management programs, dental services and related products and services. use only fair and lawful ways to collect personal information. Sometimes we may need to collect sensitive information from third parties such as doctors or hospitals so we can assess risks or process claims. We may also need to ask for it from another private health insurer, if you are looking to transfer your policy. We may contact a service provider who has treated you in the past, if the information is likely to be relevant to your current treatment. 20

23 collect personal information directly from you if it is reasonable and practicable to do so. allow the principal member (the person who is responsible for paying the premium) to have complete information on all aspects of the policy, including benefits claimed under the policy. This may include disclosing your sensitive information. This is required under our contract with the principal member. We send all communications on policies that cover more than one person to the address supplied by the principal member. take reasonable steps to ensure the personal information that ahm collects, uses or discloses is accurate, complete and up-to-date. If you need to update your contact details, please let us know. take reasonable steps to protect your personal information from misuse, loss and unauthorised access, modification or disclosure. take reasonable steps to destroy or permanently de-identify personal information if we no longer need it for any purpose. on request, we will give you access to the personal information we hold about you. If any personal information we hold about you is out of date or inaccurate, we encourage you to let us know, and ask us to correct it. If we cannot deal with your request, you will receive our reasons in writing. If you want to complain about an interference with your privacy by ahm, you can visit an ahm office, call , write to Locked Bag 1006, Matraville, NSW 2036 or We will do our best to resolve your complaint as quickly as possible. If you are not satisfied with our response to your complaint, you can refer the matter to the Federal Privacy Commissioner. Director of Complaints Office of the Federal Privacy Commissioner GPO Box 5218, Sydney NSW 1042 Telephone:

24 All Enquiries: Claims: Call Centre Hours: Monday to Friday, 8:30am - 5pm (Australian Eastern Standard Time) ahm OSHC, Locked Bag 1006, Matraville NSW Web: ahm.com.au/oshc Fax: Emergency service helpline: Emergency medical assistance Stress and trauma counselling Interpreter service Updated July 2011 Australian Health Management Group Pty Limited ABN A private health insurer

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